BACKGROUND AND OBJECTIVES: Intracardiac electrocardiographic finding using as a guide for selective catheter ablation in patients with AV nodal reentrant tachycardia (AVNRT) is not specific. Therefore, we evaluated the efficacy and safety of the anatomical approach for catheter ablation in patients with AVNRT. MATERIALS AND METHOD: Among the patients diagnosed as AVNRT by electrophysiologic study, total 66 patients (M:F=26:40) were included in this study. In the right anterior oblique radiographic view, the septal annulus of tricuspid valve, extending from the most posterior region of the annulus adjacent to coronary sinus ostium (posterior) to His bundle recording site (anterior), was divided into posterior (P), mid (M), and anterior (A) sites. Radiofrequency (RF) energies were applied from the posterior part to the anterior part sequentially along the septal annulus of tricuspid valve until successful ablation. RESULTS: Successful anatomical sites were located in posterior (11 patients), mid (48 patients), and anterior (7 patients) sites. The most patients (62 patients) were treated with slow pathway ablation except 4 patients in whom fast pathway was ablated. Probable slow potentials were observed in 8 patients (12%, 3 in posterior sites and 5 in mid sites). Transient complete AV block followed by first degree AV block and delayed complete AV block was occured in one case whose ablation site was A1. And another 3 patients had postablation first degree AV block. CONCLUSION: In patients with AVNRT, the ablated pathway were different according to successful anatomical site. And RF catheter ablation of atrioventricular nodal reentrant circuit guided by anatomical landmark is safe and efficacious.
Atrioventricular Block ; Bundle of His ; Catheter Ablation* ; Catheters* ; Coronary Sinus ; Electrocardiography ; Humans ; Tachycardia, Atrioventricular Nodal Reentry* ; Tricuspid Valve

STATEMENT OF PROBLEM: HA has been used as a coating material on Ti implants to improve osteoconductivity. However, it is difficult to form uniform HA coatings on implants with complex surface geometries using a plasma spraying technique. PURPOSE: To determine if Ti6Al4V sintered porous-surfaced implants coated with HA solgel coated and hydrothermal treated would accelerate osseointegration. MATERIALS AND METHODS: Porous implants which were made by electric discharge were used in this study. Implants were anodized and hydrothermal treatment or HA sol-gel coating was performed. Hydrothermal treatment was conducted by high pressure steam at 300 degrees C for 2 hours using a autoclave. To make a HA sol, triethyl phosphite and calcium nitrate were diluted and dissolved in anhydrous ethanol and mixed. Then anodized implant were spin-coated with the prepared HA sols and heat treated. Samples were soaked in the Hanks' solution with pH 7.4 at 37 degrees C for 6 weeks. The microstructure of the specimens was observed with a scanning electron microscope (SEM), and the composition of the surface layer was analyzed with an energy dispersive spectroscope (EDS). RESULTS: The scanning electron micrographs of HA sol-gel coated and hydrothermal treated surface did not show any significant change in the size or shape of the pores. After immersion in Hanks' solution, the precipitated HA crystals covered macro- and micro-pores. The precipitated Ca and P increased in Hanks' solution that surface treatment caused increased activity. CONCLUSION: This study shows that sol-gel coated HA and hydrothermal treatment significantly enhance the rate of HA formation due to the altered surface chemistry.
Calcium ; Chemistry ; Dental Implants* ; Ethanol ; Hot Temperature ; Hydrogen-Ion Concentration ; Immersion ; Osseointegration ; Plasma ; Steam

No abstract available.

We have experienced a reexpansion pulmonary edema(RPE) during general anesthesia. This patient has undertaken the decortication operation due to right sided massive pleural effusion and fibrothorax. Generally reexpansion pulmonary edema is believed to oceur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid in pneumothorax and pleural effusion. The pathogenesis of RPE is unknown and is probably multifactorial. The implicated etiologies are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant and pulmonaty artery pressure changes. The outcome of RPE may be fatal, so physician treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complieation.
Airway Obstruction ; Anesthesia, General* ; Arteries ; Capillary Permeability ; Humans ; Lung ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema*

No abstract available.

Fibromatosis in childhood is a rare tumor and also prone to aggressive behavior. This tumor may spread to involve contiguous soft parts and osseous structures, but does not metastasize. We experienced a case of fibromatosis in an 12-year-old giri who complained of palpable masses in the region of the right buttock and right foot. The case has been followed for 6-years since February 1973. Bony change has occured even after several attempts of surgical excision but a distant metastasis has not occured.
Buttocks ; Child ; Fibroma ; Foot ; Humans ; Neoplasm Metastasis

There are substantial evidences indiacting that anesthesia and surgery produce significant suppression of immune function. It is generally recognized that immunosuppressive manifestations such as lymphopenia, granulocytosis, decreased transformation to various antigens and impaired neutrophil chemotaxis could be followed by surgical operation. anesthetic agents may also have both direct and hormone-mediated indirect effects on immune systems. Recent evidences indicate that immunosurveillance mechanisms are not only important in the management of emerging infection and malignancy, but also critical to successful elimination of microscopic residual tumor after operation. This study was done to investigate the effeets of halothane anesthesia on T-lymphocyte subpopulations in patients undergoing hysterectomy. Lymphocyte, granulocytes and T-lymphoeyte subpopulations were counted before, during and after anestesia. The results showed that the decrease in the CD4+ cells (helper/inducer T-cells) was bigger than the decrease in the CD8+ cells (suppressor/ cytotoxic T-cells). CD3+ cells (total T-cells) and CD45R+ cells were also decreased. However, these decrease turned to normal values in 5 days. The overall result of this study suggest that anesthesia with halothane may bring temporal suppressive effect on the immunologic responses.
Anesthesia* ; Anesthetics ; Chemotaxis ; Granulocytes ; Halothane* ; Humans ; Hysterectomy ; Immune System ; Lymphocyte Subsets* ; Lymphocytes* ; Lymphopenia ; Monitoring, Immunologic ; Neoplasm, Residual ; Neutrophils ; Reference Values ; T-Lymphocytes

Chronic mucocutaneous candidiasis is a rare syndrome characterized by persistent and refractory infection of the skin, nail and mucosal tissue by yeasts of the genus Candida. A 70-year-old woman presented with the following skin lesions: ill-defined annular shaped whitish macules on the upper and lower lips accompanying dryness, pain and burning sensation, and yellowish discoloration with onycholysis of the right 4th finger nail. The upper lip lesion showed histopathologic feature of band-like infiltration of lymphocytes in the upper dermis, consistent with lichen planus. But, systemic glucocorticoid was not effective in treating erosive lip lesions. KOH examination and fungal culture of specimens from the upper lip showed hyphal elements and growth of Candida albicans, respectively. Antifungal agent was administered. After the oral medication, skin lesions were improved but there was repeated recurrence. We report a case of chronic mucocutaneous candidiasis misdiagnosed as lichen planus.
Burns ; Candida ; Candida albicans ; Candidiasis, Chronic Mucocutaneous ; Dermis ; Female ; Fingers ; Humans ; Lichen Planus ; Lichens ; Lip ; Lymphocytes ; Mucous Membrane ; Nails ; Onycholysis ; Recurrence ; Sensation ; Skin ; Yeasts

Plantar vein thrombosis is a rare condition, which can cause foot pain when walking. The cause of thrombosis is not clear. We experienced a case of plantar digital vein thrombosis which occurred in the left big toe. The patient was a 35-year-old man who presented with foot pain when during walking since one month ago. There was a solitary skin colored nodule on the left big toe. Skin punch biopsy was performed, and the diagnosis of plantar digital vein thrombosis was made. Plantar digital vein thrombosis is a very rare cause of toe pain. We herein report this interesting case.
Adult ; Biopsy ; Diagnosis ; Foot ; Humans ; Skin ; Thrombosis* ; Toes ; Veins* ; Walking

Pneumothorax was recognized as a potential hazard of mechanical ventilation after tracheal intubation. Excessive pressure the trachea during general anesthesia could produce lung rupture and pneumothorax. The incidence of pneumothorax has increased as a result of increased application of invasive diagnostic and therapeutic procedures. Emphysematous bleb rupture afterlaryngospasm, bronchospasm, or cough may be causes of pneumothorax. Tension pneumothorax during anesthesia is often difficult to diagnosis, but it needs prompt dignose and treatment. We experienced 3 cases of tension pneumothorax during and after general anesthesia.
Anesthesia ; Anesthesia, General* ; Blister ; Bronchial Spasm ; Cough ; Diagnosis ; Incidence ; Intubation ; Lung ; Pneumothorax ; Respiration, Artificial ; Rupture ; Trachea